Section reports

The Illinois Section Annual Meeting was held on September 29. The meeting’s theme was “A Day at the Office: Clinical Pearls for the Generalist.” Sessions focused on complex adnexal masses, ultrasound anomalies, menopause management, genetics, pelvic pain, urinary incontinence, infertility, robotic surgery, and labor and delivery.

Mara P. Quinlan, MD, section vice chair, traveled to Peoria on September 19 to speak on behalf of the section at a conference addressing “Payment Reform to Reward Best Practice: Eliminating Early Elective Deliveries,” hosted by Quality Quest for Health of Illinois and the University of Illinois College of Medicine at Peoria.

The Illinois Section continues to participate in the Quality Quest for Health of Illinois Healthy Babies, Healthy Moms project. A toolkit on eliminating early elective deliveries is being prepared.

For those interested, ACOG is hosting a coding workshop in Chicago on April 12–14. The workshop consists of three modules, and the format enables physicians to choose the topic or topics of interest to them. More information is available on the ACOG website.

The 2012 Iowa Section Fall Meeting was held as part of the University of Iowa Ob-Gyn Postgraduate Conference on October 26. The meeting’s keynote speaker was Douglas W. Laube, MD, MEd, past ACOG president and University of Iowa alumnus. He spoke about CenteringPregnancy and his experiences as a Jefferson Science Fellow for the US Department of State.

The 2013 Iowa Section Fall Meeting will be held October 18 at the hotelVetro & Conference Center in Iowa City. The program will focus on controversies in the care of women with preeclampsia. Please save the date.

The Iowa Section voted to maintain its financial support of the Leopold Society (a medical student ob-gyn interest group) at the University of Iowa and resident travel to participate in international medical missions. The section will also continue to pay for residents’ ACOG dues and for four Fellows and Junior Fellows to attend the ACOG Congressional Leadership Conference, The President’s Conference.

After the success of the First Annual Iowa Section Lobby Day in February 2012, the Iowa Section is partnering with the Iowa Medical Society (IMS) for a repeat performance on February 6. Information is available on the IMS website. Marygrace Elson, MD, section vice chair and legislative chair, has emailed all section members inviting them to participate.

Legislative initiatives in Iowa include medical tort reform, licensing of lay midwives and naturopaths, scope-of-practice issues for midlevel providers, truth in advertising for midlevel providers, and model legislation preventing shackling of prisoners in labor. Kimberly K. Leslie, MD, University of Iowa ob-gyn chair, was quoted in local newspapers supporting ACOG’s position for over-the-counter sale of oral contraceptives. The Iowa Section remains active in local and national advocacy efforts while engaging Junior Fellows and medical students.

In October, Iowa Section Junior Fellows held a diaper drive for families in need during the holiday season. More than 1,000 diapers were donated along with other supplies and monetary gifts. Given the success of this year’s drive and another diaper drive held in 2011, it’s likely the service project will become an annual event

The province of Manitoba is a great place to learn, practice, and teach medicine. The challenge for its physicians is to provide equal and quality care to all Manitobans. Unfortunately, Manitoba’s population density is quite unequal, and geographic distance contributes to health care resource disparities. Physician numbers also tend to congregate in urban areas.

The College of Physicians and Surgeons of Manitoba is working to streamline its registration and licensure processes to allow qualified physicians to practice in the province. A top priority is to train, recruit, and repatriate high-quality Manitoba students in an attempt to improve their retention rate. A goal of 70% retention has been targeted by a review committee consisting of members from the College, Manitoba Health, and the University of Manitoba.

Manitoba Health is providing leadership and financial support to promote enhanced multimedia opportunities to improve health care equity across the province’s geographic areas.

Manitoba, like the rest of Canada, continues to struggle with an intravenous drug shortage and back order problem. Due to a partial shutdown of the Sandoz manufacturing plant in Quebec, a broad range of injectables are in short supply. Shortages are expected to continue for at least the next year.

The Royal College of Physicians and Surgeons of Canada has undertaken a new project to reach national consensus on medical resident duty hours. The project is funded by Health Canada. Fellows of the College were invited to contribute feedback. As expected, their views varied greatly.

Significant support does exist for achieving a national consensus through evidence-informed examination of resident duty hours, directions, and best practices. While the current project is focused on resident hours, final recommendations will shape future discussions on work hours for practicing physicians as well.

Manitoba’s population growth in the past year exceeded the national rate for the third consecutive year. The increasing number of births has created an unprecedented problem in Winnipeg. There are currently two level three institutions in the city that provide all obstetric services, excluding deliveries done at home or in the free-standing birth center run by midwives.

St. Boniface General Hospital (SBGH) is currently 122 deliveries over its year-to-date budget. The hospital is funded for the safe delivery of 5,407 babies. According to program team leaders, the hospital’s physical space is unable to handle any number greater than that. There has also been an 8% increase in the number of visits to the obstetric triage unit, further adding to workload and budgetary concerns.

To avoid having sanctions imposed on the current caregivers working at the SBGH obstetric unit, a number of solutions have been proposed, including:

Granting no new obstetric privileges at SBGH

Transferring out-of-town referrals to Health Sciences Center Winnipeg (HSC), the other level three institution in the city

Performing some of SBGH’s elective cesarean deliveries at HSC

Capping the number of prenatal patients seen by SBGH physicians

Sending one low-risk induction of labor patient to HSC daily, regardless of space availability at SBGH

Employing one attending from SBGH to represent the two call groups for SBGH patients at HSC

These solutions have not been met with a positive reaction from the practice groups involved. Further clarification of budget issues, workloads, and patient preferences for delivering hospitals is being sought.

The Mayo Clinic ob-gyn department held its second annual diaper drive in September. Residents, fellows, staff physicians, and nurses asked for donations from local businesses in Rochester and their patrons on two Saturdays. They collected nearly 15,000 diapers, which were donated to the local Women, Infants, and Children’s Program (WIC).

Congratulations to Diane Horvath-Cosper, MD, past District VI and section Junior Fellow chair, who won the 2012 ACOG Junior Fellow Essay Contest on “Advocacy and the Importance of Supporting Patients Beyond the Exam Room.” Her essay was published in the October 2012 issue of Obstetrics & Gynecology.

Bridget B. Keller, MD, section chair, spoke at an event planned by several Minnesota certified nurse-midwives on maternal morality called “Maternal Outcomes Matter” in October. The event featured a keynote address by Christy Turlington Burns and a special screening of her documentary “No Woman, No Cry.” Meeting attendees participated in an awareness walk, traveling the average distance pregnant women must walk in developing countries to receive prenatal and obstetric care.

The Minnesota Maternal Mortality Committee has met twice and is reviewing a backlog of cases. Members are working on a system that will capture more of the maternal deaths that occur postpartum and within one year of pregnancy. The multi-disciplinary committee is a collaborative project with the Minnesota Department of Health. Elizabeth P. Elfstrand, MD, presented committee data and a few interesting cases at the Minnesota Section Annual Meeting in December.

Nebraska
Nebraska Section Junior Fellows joined members from the Luikart Society (a medical student ob-gyn interest group at the University of Nebraska Medical Center) to form a team for a local March of Dimes March for Babies last fall. They met their fundraising goal for the event and had a great turnout. Junior Fellows also hosted their second annual diaper drive recently, and it was a great success.

The Metro Ob-Gyn Omaha Community Working Group continues to meet and work with hospitals and health systems in the area on patient safety issues. The group distributed community-wide protocols in November in conjunction with Prematurity Awareness Month. Next, it will circulate a delivery scheduling form and standards for electively scheduled deliveries.

Traditionally, the Nebraska Section Annual Meeting has been held in conjunction with the Nebraska Ob-Gyn Society Annual Meeting in Las Vegas. Due to changing times, this arrangement has become a less effective way to hold the meeting. The section is considering options to change the timing, venue, and format of its annual meeting.

In an attempt to increase patient safety, the North Dakota Board of Pharmacy is encouraging physicians to use the North Dakota Prescription Drug Monitoring Program (PDMP) to gain information about patient use of controlled substances. The PDMP was created to improve patient therapy and the state’s ability to identify and inhibit the diversion of controlled substances without impeding the appropriate use of these drugs for legitimate medical purposes.

The North Dakota Health Information Network Clinical Work Group is soliciting feedback from providers on what laboratory panels and tests should be available in the network’s virtual health record system. This is an important step in ensuring the network is a usable and valuable tool for all health care professionals.

The North Dakota Society of Ob-Gyns held its annual meeting in the breathtakingly beautiful Badlands of western North Dakota in the historic town of Medora. The meeting’s program included didactic sessions from Mark Evans, MD, on the next generation of prenatal diagnoses and Douglas W. Laube, MD, MEd, past ACOG president, on CenteringPregnancy and global disparities in women’s health care.

In September, Saskatchewan Section members participated for the third time in Ovarian Cancer Canada’s Walk of Hope as Team Gyne-o-mite. They raised $4,195, which will help support women and families who have been affected by ovarian cancer, as well as ovarian cancer awareness, education, and research programs. The weather was beautiful, and family and friends joined in the walk along the South Saskatchewan River.

Marj Lens, ob-gyn resident program administrator at the University of Saskatchewan, has become the first residency program administrator in Canada to be certified by the Canadian Administrators in Medical Education Operations. Her certification was part of a pilot project that is gaining momentum in Canada. She also plans to complete the American Training Administrators of Graduate Medical Education certification to broaden her understanding of the complexities of residency administration.

Annette M. Epp, MD, division chief of urogynecology at the University of Saskatchewan, has started working shifts at Student Wellness Initiative Toward Community Health (SWITCH)—an inner-city, interdisciplinary, student-run health clinic. Her goal is to improve the health of underprivileged women and children in Saskatoon.

SWITCH was created by students at the University of Saskatchewan to enrich educational experiences and provide services for Saskatoon’s core neighborhoods. The clinic was recently featured on a national Canadian Broadcasting Corporation radio program on health care called “White Coat, Black Art.”

Use of checklists has become established in surgery and gynecology units in Saskatchewan with greater than 95% compliance. Checklists are being introduced in obstetric units with fewer uptakes so far. There is a major focus on safe medication practices within these checklists.

The number of patients waiting for surgery is decreasing and on target to reach the Saskatchewan Surgical Initiative’s goal—for no one to have to wait for elective surgery for more than three months by 2014. There has been an increase in day surgeries and moderate sedation surgeries as part of this process.

Work to establish a maternal morbidity and mortality committee in South Dakota is ongoing. The state has an informal committee at this time. An official committee will be organized as part of the Annual South Dakota Perinatal Conference.

Rural citizens of South Dakota continue to experience issues accessing care. The South Dakota Section is working to raise public awareness of the need for early prenatal care for these patients.

Currently, there are efforts within South Dakota’s two major medical systems to provide more educational opportunities. ACOG has been an excellent resource in implementing patient care initiatives and enhancing patient safety, especially in the more rural areas of South Dakota.

The section would like to involve ACOG more with local programming to show members what the organization is doing to support physicians locally. South Dakota ob-gyns are discussing the establishment of a local ob-gyn society with regular meetings to facilitate more dialogue between the state’s health systems.

An ob-gyn residency program is being developed in Sioux Falls for 2015. There will be three resident positions available each year if the program is approved.

Six new Junior Fellows have started practice in South Dakota over the past year. Previously, there has not been much activity from South Dakota Junior Fellows due to low numbers. Section leaders hope Junior Fellow involvement will increase with this infusion of members.

The 2012 Wisconsin Section Annual Meeting was held in August. The meeting had 77 attendees—32 were Junior Fellows in training and eight were from out of state. Thank you to Paul G. Tomich, MD, past District VI chair and District VI Junior Fellow advisor, and Jacques S. Abramowicz, MD, Illinois Section chair, who spoke at the meeting. The meeting was planned and orchestrated by Kathy D. Hartke, MD, Wisconsin Section vice chair and legislative chair.

The 2013 Wisconsin Section Annual Meeting will be held August 1–3 at the Kalahari Resort and Convention Center in the Wisconsin Dells. Everyone in District VI is welcome to attend! More information will be available on the Wisconsin Section website.

The Wisconsin Section’s Annual State Lobby Day is scheduled for April 12. It will be a joint event with the Wisconsin Medical Society. The event is an opportunity for any section member to meet with state senators and representatives to discuss legislative issues that affect the practice of ob-gyn and the provision of medical services in Wisconsin.

Wisconsin Right to Life plans to propose several bills that will limit women’s access to abortion this legislative session. If passed, the bills would require women seeking abortion to view an ultrasound prior to their procedure (currently, women have the option not to view it); ban abortions at 20 weeks based on the belief that fetuses at this gestation feel pain; and ban abortions that are wanted based on the sex of the fetus. In response to these proposed bills, pro-choice Medical College of Wisconsin (MCW) residents are working with faculty members and community physicians to advocate for Wisconsin women’s reproductive rights.

MCW residents participated in an adopt-a-family holiday program with the Next Door Foundation. Residents generously donated money, which was used to buy gifts for a family of three. The program provides gifts to more than 70 families in the Milwaukee area.

University of Wisconsin residents held a hands-on evening in the university’s simulation lab for the school’s medical student interest group. Additionally, residents helped fourth-year medical students applying for ob-gyn residencies with an evening of mock interviews.

The Wisconsin Section is in the process of evaluating possible funding for “Operation: Education,” a program coordinated by the Wisconsin Medical Society Foundation. The program offers students at each medical school in Wisconsin the opportunity to ask questions about the various primary and specialty care practices they may be interested in exploring. Program events are being held at each of the state’s medical schools. Ideally, each event will have practicing physician representatives from each field of expertise.

Congratulations to Anna Palatnik, MD, immediate past section Junior Fellow chair, who was accepted to the maternal-fetal medicine fellowship program at Northwestern University in Evanston, IL, and Jameca R. Price, MD, who was accepted to the female medicine and reproductive surgery fellowship at Oregon Health & Science University in Portland.